<form id="edit-form" class="form-horizontal" role="form" data-toggle="validator" method="POST" action="">

    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Buyername')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-buyerName" data-rule="required" class="form-control" name="row[buyerName]" type="text" value="{$row.buyerName|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Buyertaxnum')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-buyerTaxNum" class="form-control" name="row[buyerTaxNum]" type="text" value="{$row.buyerTaxNum|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Bill_content')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-bill_content" class="form-control" name="row[bill_content]" type="text" value="{$row.bill_content|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Bill_money')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-bill_money" data-rule="required" class="form-control" step="0.01" name="row[bill_money]" type="number" value="{$row.bill_money|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Email')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-email" data-rule="required" class="form-control" name="row[email]" type="text" value="{$row.email|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Mobile')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-mobile" data-rule="required" class="form-control" name="row[mobile]" type="text" value="{$row.mobile|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Openblank')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-openBlank" class="form-control" name="row[openBlank]" type="text" value="{$row.openBlank|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Buyeraccount')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-buyerAccount" class="form-control" name="row[buyerAccount]" type="text" value="{$row.buyerAccount|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Buyeraddress')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-buyerAddress" class="form-control" name="row[buyerAddress]" type="text" value="{$row.buyerAddress|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Buyertel')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-buyerTel" class="form-control" name="row[buyerTel]" type="text" value="{$row.buyerTel|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Member_id')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-member_id" data-rule="required" data-source="member/index" class="form-control selectpage" name="row[member_id]" type="text" value="{$row.member_id|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Status')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-status" data-rule="required" class="form-control" name="row[status]" type="number" value="{$row.status|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Orderno')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-orderNo" class="form-control" name="row[orderNo]" type="text" value="{$row.orderNo|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Pdfurl')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-pdfUrl" class="form-control" name="row[pdfUrl]" type="text" value="{$row.pdfUrl|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Reason')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-reason" class="form-control" name="row[reason]" type="text" value="{$row.reason|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Invoiceserialnum')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-invoiceSerialNum" class="form-control" name="row[invoiceSerialNum]" type="text" value="{$row.invoiceSerialNum|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Imgurls')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-imgUrls" class="form-control" name="row[imgUrls]" type="text" value="{$row.imgUrls|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Invoicedate')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-invoiceDate" class="form-control datetimepicker" data-date-format="YYYY-MM-DD HH:mm:ss" data-use-current="true" name="row[invoiceDate]" type="text" value="{$row.invoiceDate}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Orderid')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-orderId" data-rule="required" class="form-control" name="row[orderId]" type="number" value="{$row.orderId|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Invoicecode')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-invoiceCode" class="form-control" name="row[invoiceCode]" type="text" value="{$row.invoiceCode|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Invoiceno')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-invoiceNo" class="form-control" name="row[invoiceNo]" type="text" value="{$row.invoiceNo|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Type')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-type" class="form-control" name="row[type]" type="number" value="{$row.type|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Cancelinvoiceid')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-cancelInvoiceId" class="form-control" name="row[cancelInvoiceId]" type="text" value="{$row.cancelInvoiceId|htmlentities}">
        </div>
    </div>
    <div class="form-group layer-footer">
        <label class="control-label col-xs-12 col-sm-2"></label>
        <div class="col-xs-12 col-sm-8">
            <button type="submit" class="btn btn-primary btn-embossed disabled">{:__('OK')}</button>
            <button type="reset" class="btn btn-default btn-embossed">{:__('Reset')}</button>
        </div>
    </div>
</form>
